From the Guidelines
Diagnosing rosacea involves identifying two key diagnostic features: persistent, centrofacial erythema associated with periodic intensification, and phymatous changes, as recommended by the global rosacea consensus panel 1. To diagnose rosacea, a dermatologist will typically conduct a visual examination, looking for these characteristic symptoms on the central face. The following are key points to consider in the diagnosis of rosacea:
- Persistent, centrofacial erythema associated with periodic intensification is a diagnostic feature of rosacea 1
- Phymatous changes are also individually diagnostic of rosacea 1
- Flushing, telangiectasia, inflammatory papules, and pustules are not considered individually diagnostic, but may be present as part of the condition 1
- Ocular manifestations, such as dryness, irritation, or redness, may also be noted in some cases 1 There is no specific laboratory test for rosacea, and the diagnosis is based on the pattern and appearance of symptoms, patient history, and exclusion of other conditions like seborrheic dermatitis, lupus, or acne. Early diagnosis allows for prompt treatment to manage symptoms and prevent progression to more severe forms. If you suspect rosacea, seeking evaluation from a dermatologist is recommended, as they can distinguish it from similar-appearing skin conditions. The global rosacea consensus panel recommends a phenotype-based approach to diagnosis and classification, which takes into account the individual patient's experience and symptoms 1.
From the Research
Diagnosis of Rosacea
To diagnose rosacea, the following criteria can be used:
- The diagnosis of rosacea is based on the presence of either phymatous changes or centrofacial persistent erythema, as stated in the study 2.
- In the absence of phymatous changes or centrofacial persistent erythema, the diagnosis can be established by the presence of any two of the following: flushing/transient erythema, papules and pustules, telangiectases, or ocular manifestations, as mentioned in the study 2.
Clinical Features of Rosacea
The clinical features of rosacea include:
- Flushing, erythema, papules, pustules, telangiectasias, phymatous changes, pruritus, burning, and stinging, as described in the study 3.
- Four subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous, and ocular rosacea, as mentioned in the study 4.
Diagnostic Approach
The diagnostic approach to rosacea involves:
- Excluding differential diagnoses, as stated in the study 2.
- Evaluating patients for the presence of triggers such as Helicobacter pylori infection and small intestinal bacterial overgrowth, as mentioned in the study 5.
- Considering the presence of Demodex folliculorum infestation, as described in the study 5.
Classification of Rosacea
The classification of rosacea is based on the phenotype approach, which takes into account the presenting clinical features, as mentioned in the study 2. This approach is also supported by the study 3, which recommends a phenotype-based classification for therapy.